The present invention relates to instrumentation for plastic surgery of the nose, for modifying the shape of the latter (rhinoplasty), more particularly for removing an osseocartilaginous bulge from the nose and for performing lateral osteotomy of the nasal bones.
As is known, beneath the skin of the nose there is the nasal bone, extending from the halfway point of the nose to the forehead, and then the cartilage, which extends from the halfway point of the nose to the tip of the nose, the bone and the cartilage are held between the skin on the outside and the nasal mucous membrane on the inside. The septum is the cartilage which supports this arch in the centre.
The nasal bulge thus consists of an oseous half and a cartilaginous half. To perform its ablation, so as to give the nose the desired appearance, with smooth profile, the following procedure has hitherto been followed.
These two halves of the bulge (bone and cartilage) are sectioned using two different types of instruments:
a) For the cartilage, use is made of scissors whose action is halted consequently at the bone. For the bone, use is made of a straight chisel and a hammer, with which the chisel is advanced in order to remove the remaining osseous part of the nasal bulge.
Unfortunately, this technique has the disadvantage that it does not in practice prevent variations in cutting angles between the two tools. These angular deviations remain visible on the nose profiles which are obtained, even when these are considered satisfactory. For example, there may still be more bone volume on the profile compared to the line of the cartilage profile.
Once the bulge has been removed, the two bones of the nose must be brought together to reconstruct a nose of normal width. To do this, the surgeon performs lateral osteotomy of the nose, that is to say a cut from the base of the two lateral bones, in order to bring together their upper margins. This cut is made using a straight chisel and hammer, with two variations in axes, namely a variation in the horizontal plane (the patient being assumed to be lying on a horizontal plane) and a variation in axis in the frontal plane.
These two lateral osteotomies are difficult to perform in a satisfactory manner, so that the point of arrival of these cuts is not always situated at the intended location. In addition, the bone may fragment because of the variations in axes given to the chisel, which the bone does not accept. Finally, although the following is uncommon, the chisel may slip as far as the eye and cause an eye wound.
A saw is more rarely used for these lateral osteotomies. Because the cut is straight, and not curved, its angle of attack is difficult to control, and the handling of the chisel or saw is not easy. Finally, a height of bone equal to the height of the blade (2 mm) disappears. This procedure thus presents real difficulties and the result obtained is not perfect.
Finally, these known techniques necessitate the use of several different tools; in particular, the first operation, intended to remove the nasal bulge, requires two tools, or even three, including the hammer associated with the straight chisel.
The object of the invention is therefore to provide instrumentation which permits more satisfactory results, which is less difficult to use and which is also less expensive than the instrumentation used hitherto.
According to the invention, the instrumentation for plastic surgery of the nose comprises:
a pair of scissors intended to remove the bulge and having cutting blades with concave edges which face each other and are adapted to the anatomy of the bulge, and forceps, with two cutting blades each having at least one curvature in one of two perpendicular planes, and adapted to the anatomy of the lateral bones of the nose.
Thus, the pair of scissors alone allows the cartilaginous and osseous parts of the bulge to be removed in a single operation and therefore replaces the three tools mentioned above.
Likewise, the forceps replace the straight chisel and the hammer, while making it possible to perform much less difficult and more satisfactory lateral cuts than the cuts performed hitherto.
According to one feature of the invention, the end of one of the cutting blades of the pair of scissors is provided with a transverse stud directed towards the end of the second blade.
This stud can either bear on the upper end of the bridge of the nose or be embedded in one of the lateral bones of the nose in order to correctly fix the positioning of the scissors prior to cutting.
The blades and cutting edges of the scissors can also have a curvature in a plane perpendicular to the general plane of the pair of scissors.
According to another characteristic of the invention, one of the blades of the osteotomy forceps has a concave cutting edge, while the second blade is provided with a convex edge.